Time effects of intravenous lipid emulsions in prematures

Liver disease is associated with soybean lipid in Parenteral Nutrition (PN). This led to the development of alternative Intravenous Lipid Emulsions (ILE). Here we compare the effects of Lipoplus® (medium chain triglyceride combined with soybean and fish oil) in treatments of 5-7 days vs. longer treatments.Retrospective observational study using pharmacotherapeutic records of prematures who initiated PN between December 12 and May 14 in a tertiary care hospital. Infants included had a GA u003c34 weeks and birth weight between 0.5-2. Data recorded included gender, gestational age, body weight and total (TB), conjugated(CB) and unconjugated bilirubin (UB) (mg/dL). Comparisons were done with t-tests.Of the 17 infants selected, 10 (58.8%) (seven male, three female) were treated for five to seven days (Test Group) and seven (41.2%) (five male, two female) were treated for more than a week (Control Group). Mean GA was 29 weeks forboth groups. Average weight at the beginning of PN was 1.37 kg for test Groupand 1.03 kg for control Group.Differences vs. baseline were observed for either treatment:— Test Group = CB: 0.35 vs. 0.39; p = n.s. UB: 7.9 vs. 11.25; p = 0.037; TB: 8.25 vs. 11.61; p = 0.028.— Control Group = CB: 1.71 vs. 1.5; p = n.s. UB: 7.74 vs. 6.15; p = n.s. TB: 9.46 vs. 4.47; p = 0.028.A significant increase in UB and TB was observed in test group; therefore a significant decrease in TB was detected in the control group.We found that treatments from eight to 14 days with new ILE significantly lower TB levels in premature infants as described previously. On the other hand,shorter treatments have not shown the same potential. Further trials evaluating the potential hepatoprotective effects of the new ILE over different time periods on alarger number of patients are needed